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Author
Topic: Obamacare. (Read 80606 times)

The ADAP comparison falls flat. People on ADAP waiting lists have no access to coverage at all

The .6% are not going to be disenfranchised from coverage, they are just going to have to pay more for it. They will all get better coverage, in a better functioning market, but at a higher price. Previously, they were benefiting from the exclusion, from the market, of people with pre-existing conditions. A situation which, at any time, they could find themselves in too. If you eliminate all the sick people from the insurance pool, of course premiums will be lower.

I'm not saying, nor are the authors of this study saying, nor have I heard anyone else say, that the changes for these people are not important - especially to them. But this group has received wall to wall coverage, especially in right wing media, aided and abetted by the lazy "main-stream" media to the exclusion of all the positives taking place. A little proportionality would be nice.

The functioning of the insurance market has been made dramatically better for everyone. 99.4% of all the people in this country will pay the same or less. No one with a pre-existing condition can ever be denied coverage again. No annual caps, no lifetime caps, etc. etc.

Talk about broken promises all you want. This seems like an excellent outcome to me.

P.S. Medicare for all !!

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"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

"under the ACA, at least 80 percent of premiums must now pay for health care. If a plan falls short of that standard, it must refund the difference to consumers. This requirement, which began in 2011, has already reduced premiums by an average of 7.5 percent for consumers in the individual market."

^^^^^that's all consumers.

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"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

some people have already been receiving refund checks from their insurance companies because of this provision.

for anyone receiving notices of insurance premium increases, just remember since the ACA already requires your insurance to maintain the medical loss ratio, your insurance is rising because of your greedy insurance company not "Obamacare". To those people, I recommend checking the marketplace for a new insurer. The free market has been and will continue to weed out some of these greedier insurance companies.

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leatherman (aka mIkIE)

All the stars are flashing high above the seaand the party is on fire around you and meWe're gonna burn this disco down before the morning comes- Pet Shop Boys chart from 1992-2015Isentress/Prezcobix

The ADAP comparison falls flat. People on ADAP waiting lists have no access to coverage at all

The .6% are not going to be disenfranchised from coverage, they are just going to have to pay more for it. They will all get better coverage, in a better functioning market, but at a higher price. Previously, they were benefiting from the exclusion, from the market, of people with pre-existing conditions. A situation which, at any time, they could find themselves in too. If you eliminate all the sick people from the insurance pool, of course premiums will be lower.

I'm not saying, nor are the authors of this study saying, nor have I heard anyone else say, that the changes for these people are not important - especially to them. But this group has received wall to wall coverage, especially in right wing media, aided and abetted by the lazy "main-stream" media to the exclusion of all the positives taking place. A little proportionality would be nice.

The functioning of the insurance market has been made dramatically better for everyone. 99.4% of all the people in this country will pay the same or less. No one with a pre-existing condition can ever be denied coverage again. No annual caps, no lifetime caps, etc. etc.

Talk about broken promises all you want. This seems like an excellent outcome to me.

P.S. Medicare for all !!

You missed my point entirely!

I wasn't disputing that the media has blown this bigger than it really is, but you are doing just the opposite -- minimizing the impact to hundreds of thousands (or millions) that it does impact. Hyperbole goes both ways.I used the ADAP example to point out that the impact to something is very large to the individuals affected. even if it is miniscule to the overall population. You, unfortunately, tried to tie this to coverage -- I wasn't talking about coverage or insurance, per se -- I was talking about overblowing and underplaying impact in anything.

The comparison between ADAP wait lists and some people getting better coverage but having to pay more for it is not a valid comparison.

And you missed the point that all of those people who will be paying more will be buying into a greatly improved market situation - even for them. They are getting something for those additional dollars. That's virtually never reported or discussed. There is a value add for the extra cost. They're not being punished.

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"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

Exactly. A major change in our standard of healthcare may cost some a bit more.... with better benefits. It comes with the territory in a similar fashion that any changes in the tax code has it's implications.

If I were better off financially and had to pay more for health insurance for the good of our society as a whole I would be happy to do so.

We need to have a more fair and equitable system and the ACA is heading in that direction regardless if .06% are forced to pay a bit more.

Are there problems that still need tweeking? Yup, but this "concern" about the .06% paying more has been hyped beyond belief. The GOP is grasping for anything they can do to prevent moving forward in a positive way. Sad.

Kinda what has been chapping my behind the last few weeks, is how Obama and his minions say that these plans are "junk" and most people don't realize how bad they are and that when you get sick they drop you and don't cover you. Greedy insurance companies and all.

Although for the most part they are backing off that mantra, at least a bit now.

Yes I realize there are some bad policies out there, but one size does not fit all. No one hears about the great policies.

But someone telling me that my private policy is junk and I don't realize how bad it is rather offensive to me. I've had my policy since before I was HIV+, My policy has kept me in HIV meds, and alive for 5 years. I was in the ICU for 5 days at one point.. and guess what, they covered it. Yes, Ive taken alot of premium increases over the years, and it is very expensive, but they've never dropped me, and Im alive. We have a mutually beneficial relationship, I send them money each month, they give me the ability to receive medical attention. I would be HIGHLY upset if they dropped me, I realize the letter could come any day and quite frankly have lost sleep over it a couple nights.

and yes, I am trying to look for policies in the exchange, but it's not as easy as you would think, and with things changing daily I'm kinda sitting on the sidelines for now.

Well, you unfortunately might not have as much success as I did for a variety of reasons. That's why it needs tweeking.

The fact that insurance companies can still decide who is in network seems to be your major issue and understandably so. Tweek needed. There are so many awful reasons why this may never happen. The biggest one is that insurance companies need to be profitable, hence the need for Medicare for all.

I'm still willing to bet that you will make out ok. Not ideal, but ok.

Maybe your current policy complies with the ACA. Why don't you just call your insurance company instead of losing sleep? At least you will have an answer if your policy is subject to cancelation.

Maybe your current policy complies with the ACA. Why don't you just call your insurance company instead of losing sleep? At least you will have an answer if your policy is subject to cancelation.

I'm pulling for you Will.

Thanks Mitch.

Mine is substandard because I don't have Maternity coverage. I wonder If I could just add that for a small fee? I'm grandfathered since I had it prior to the ACA law, but I am still nervous of the dreaded "letter"

I guess the people that are forced to make an inconvenient but rarely a more costly switch in insurance will have to make up their own mind if that sacrifice is worth making to insure that many will have access to insurance and decent healthcare for the first time in the history of this country . That's not the way it was sold to us but what its coming down to .

I guess the people that are forced to make an inconvenient but rarely a more costly switch in insurance will have to make up their own mind if that sacrifice is worth making to insure that many will have access to insurance and decent healthcare for the first time in the history of this country . That's not the way it was sold to us but what its coming down to .

The comparison between ADAP wait lists and some people getting better coverage but having to pay more for it is not a valid comparison.

And you missed the point that all of those people who will be paying more will be buying into a greatly improved market situation - even for them. They are getting something for those additional dollars. That's virtually never reported or discussed. There is a value add for the extra cost. They're not being punished.

No dear, you missed my point. My point is not really about Obamacare, it is about reading whatever your preconceived idea is into stats. You are not reading my posts to understand, you are simply reading to reply how I am wrong and you are right.You see, I agree (for the most part) with your Obmacare point, but not with your take on the stats.

I know probably beyond your comprehension, but I tried. Or perhaps you simply being obtuse

No dear, you missed my point. My point is not really about Obamacare, it is about reading whatever your preconceived idea is into stats. You are not reading my posts to understand, you are simply reading to reply how I am wrong and you are right.You see, I agree (for the most part) with your Obmacare point, but not with your take on the stats.

I know probably beyond your comprehension, but I tried. Or perhaps you simply being obtuse

That's a little harsh don't you think we should be able to talk about these things without using insulting language or condescending to one another .

Kinda what has been chapping my behind the last few weeks, is how Obama and his minions say that these plans are "junk" and most people don't realize how bad they are and that when you get sick they drop you and don't cover you. Greedy insurance companies and all.

Although for the most part they are backing off that mantra, at least a bit now.

Yes I realize there are some bad policies out there, but one size does not fit all. No one hears about the great policies.

But someone telling me that my private policy is junk and I don't realize how bad it is rather offensive to me. I've had my policy since before I was HIV+, My policy has kept me in HIV meds, and alive for 5 years. I was in the ICU for 5 days at one point.. and guess what, they covered it. Yes, Ive taken alot of premium increases over the years, and it is very expensive, but they've never dropped me, and Im alive. We have a mutually beneficial relationship, I send them money each month, they give me the ability to receive medical attention. I would be HIGHLY upset if they dropped me, I realize the letter could come any day and quite frankly have lost sleep over it a couple nights.

and yes, I am trying to look for policies in the exchange, but it's not as easy as you would think, and with things changing daily I'm kinda sitting on the sidelines for now.

I found myself Jealous of Mitchypoo and his success

Well the "Junk Policy" are the one that do not include the new required min coverage. So all policies that do not include Maternity or Pediatric coverage are being canceled as they are considered "Junk Policies" So now there be a part of the population that will be required to carry this coverage and may never use it.

Well the "Junk Policy" are the one that do not include the new required min coverage. So all policies that do not include Maternity or Pediatric coverage are being canceled as they are considered "Junk Policies" So now there be a part of the population that will be required to carry this coverage and may never use it.

They are not junk , they just don't meet the minimum requirements set forth in the new law .

I currently have a PCIP plan that will expire at the end of the year. This plan was paid for by Ryan White/ADAP on my behalf.

I will going onto a plan through Assurant Health. Which is a policy outside the exchange here in NH.

In NH I can only buy a policy through Anthem BC/BS and my current doctor is outside the network and they do not cover my medication(Stirbild)

It's Bronze plan with 3,500$ over all deductible, 500$ Brand RX Drugs, and 50% copay on all services.

The Ryan White/ADAP will cover my cost of the premium and all co-payments to services related to HIV. So basically it's a good deal for ADAP as they only pay for a 500$ on my medication for the year, however any normal heath care items I will be forced to pay for 50 percent out of pocket. They do cover all preventive care/screening/immunization at 100%

Well the "Junk Policy" are the one that do not include the new required min coverage. So all policies that do not include Maternity or Pediatric coverage are being canceled as they are considered "Junk Policies" So now there be a part of the population that will be required to carry this coverage and may never use it.

Paying for something and not getting anything from it happens in many areas not just with health insurance. Most of my property taxes go toward the school system. I have no children. It's all about helping our society as a whole. We HIV+ folks get MUCH more out of the system than we put in.

I'm just grateful that the ACA plans don't charge the ridiculous premiums that I was stuck with for my entire life. It's a shame that some states don't have much competition and/or that the networks are so limited. It still needs work (or replacement with a single payer system).

Willy,From memory, didn't you say that you earn too much to qualify for a subsidy on the exchange?

If so then why are you going through the exchange at all? If you are not getting Medicaid or a subsidy then you shouldn't even need to use the exchange at all.

I may have your situation confused with someone else.

No subsidies for me.

I was looking to see If I could save any money, I am basically in the same situation as Mitch (he went from private policy to cheaper policy on exchange).

Currently I am "grandfathered in" on the private policy even though Obama considers it substandard. I'm also not kidding myself, I know that at some point my private policy will cease to exist and I will be forced on exchange.

In your situation you don't need to use the exchange at all - unless you want to. You certainly won't be forced too.

Currently, people who get Medicaid or a subsidy need to use the exchange, but their options will be expanding soon too.

It seems to be a widely held belief that all people must use the exchange when in fact that is not the case.

Shopping on the exchange does make things easier. Once you have found a policy you like you can choose to contact the insurance company directly. If you have trouble setting up an account or have concerns about security, or you're afraid that the gov't may implant a chip in your brain, don't use the website at all.

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"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

I was looking to see If I could save any money, I am basically in the same situation as Mitch (he went from private policy to cheaper policy on exchange).

Currently I am "grandfathered in" on the private policy even though Obama considers it substandard. I'm also not kidding myself, I know that at some point my private policy will cease to exist and I will be forced on exchange.

I have received the best of healthcare from medicare and I agree with Miss P . Its medicaid that makes me able to make ends meet though . Without the extra help I would rack up unsustainable proscription drug copay's and medical bills .

I have received the best of healthcare from medicare and I agree with Miss P . Its medicaid that makes me able to make ends meet though . Without the extra help I would rack up unsustainable proscription drug copay's and medical bills .

Yes, that too -- I have this program here called M.A.W.D. (Medical Assistance Benefits for Workers with Disabilities) which basically allows me to pay a monthly premium and have Medicaid as a secondary insurance so it picks up that pesky 20% of medical bills that Medicare doesn't pay. My premium is $98/month and my Medicare premium is $105 so I shell out $203/month for my health.

Medicare Part D pays for my prescriptions though, and I'm not even sure who pays for that premium but someone does -- I think it's the PA Dept. of Health. I have an annual deductible but I forget how much it is -- I end up paying some co-pays for the first two months of the year and then the rest of the year I pay nothing.

It galls me the Republican pundits invited onto libtard shows like Bill Maher, and the extremely cynical, completely asinine GOP talking points they blather on about the wrongs of Affordable Care. There are problems but the GOP offers no freaking alternative. Thank god for independent thinkers like Dan Savage. I am not even a huge fan of his but at least he can make a counter jab at the GOP pundits and he isn't even for Affordable Care, being a purist, he supports single payer. Its deplorable, the dumbass arguments, obstructionist tactics, destroy destroy destroy cynicism of people who we KNOW can afford health care no matter the delivery system... Jesus Christ and they go BLANK when confronted with the comparison charts of bang for the buck, American system versus other advanced industrialised democracies... Blank. Or obfuscation. Because freedom. Because American exceptionalism. It is so freaking inhumane not to mention against all the tenants of every major religious morality I can think of. Its fucking craven.

There, I had my screed. Sorry.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

I have received the best of healthcare from medicare and I agree with Miss P . Its medicaid that makes me able to make ends meet though . Without the extra help I would rack up unsustainable proscription drug copay's and medical bills .

Agreed. Like Miss P, I receive Medicaid for working disabled people, but in Indiana it's called MED Works. I pay $107/month for it. It pays the Medicare premiums, makes extra help possible, and picks up the 20% Medicare doesn't pay. For my Medicare Part D plan, I pay $9/month, and the meds are all paid for. So far. So, I pay a total of $117/month for healthcare but the payoff is invaluable.

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I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

I heard on the local news that our state enrolled 100,000 people so far. I wish the media would talk about the successes more than just the failures. I think that's a huge amount.

I'm sure Faux News will track down and report on the last person in the country to have an issue with the site and demand repeal. They will also focus on the very small minority of those who end up paying more even after the website is fixed. It's their job after all.

The good news stories will FAR outweigh the bad news stories as more people sign up. I think Obamacare is here to stay for years to come. Next: A single payer system. Too optimistic?

Very interesting. Lots of myths busted. Sadly, learning from other countries doesn't seem to be our strong suit.

Er. Socialism! Marxism! Because, Freedom!Hillary learned all these lessons first year of her hubby's Presidency. She was laughed if not ramrodded off the Hill. If I remember, she presented a model modified on the Swiss system. Cause its still pretty capitalist. Regulated free market, you might say. All the companies are still private here. Everybody must buy. Every company must offer a basic, pretty comprehensive policy. Noone can be refused a basic policy. Very poor get subsidies to pay their premiums. It's holding, but who knows what the future will bring...

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“From each, according to his ability; to each, according to his need” 1875 K Marx

Er. Socialism! Marxism! Because, Freedom!Hillary learned all these lessons first year of her hubby's Presidency. She was laughed if not ramrodded off the Hill. If I remember, she presented a model modified on the Swiss system. Cause its still pretty capitalist. Regulated free market, you might say. All the companies are still private here. Everybody must buy. Every company must offer a basic, pretty comprehensive policy. Noone can be refused a basic policy. Very poor get subsidies to pay their premiums. It's holding, but who knows what the future will bring...

So, is what you are saying is that the Swiss healthcare model is potentially failing?

I don't know enough about it to say its failing or not. Insurance companies do occasionally belly up here. But there are lots of companies so maybe its bad management. My guess is the day the present system becomes unreliable, the Federal government will fund another solution. The luxury of rich, functioning European states... I think we don't have the military sink hole. I was just reading about the Metro North derailment. Many people griping about the poor state of American public transport, not to mention roads and bridges, etc. Comparing to some European utopia.Yet I have heard Germany also faces a big burden because of delayed infrastructure investment. Yeah, its better here, but these sorts of things - the so-called socialist benefits of advanced and mostly capitalist economies - they take constant constant tweaking and constant reinvestment... Reunification cost a shit load. Then during the new crisis, the Germans have preached austerity and thus, yeah, better infrastructure was in place but overall, there are major challenges going forward. Now Britain, trying to sort out how to pay for its top flight university system... The key to me is that a country makes its social welfare commitments and does what is necessary to stick to them... Bush Jr. toured Europe, before the American financial collapse, on a propaganda tour telling heads of states the only model was the American model, and the social welfare states were unsustainable. Then he delivered his epic catastrophe of the pure capitalist formula.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

My students are getting 45k a year educations for about 1k a year out of their pockets or subsidies. (many do get subsidies but not all.) But we are all paying for that in taxes. The US states shouldn't have let their state university systems become unaffordable, in my opinion. Etc etc etc. What can you cut, to pay for the things you consider essential, or necessary. Who (and what, since IMO corporations are not people) can you tax, to get the revenues necessary. Not easy, right?

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“From each, according to his ability; to each, according to his need” 1875 K Marx

I don't know enough about it to say its failing or not. Insurance companies do occasionally belly up here. But there are lots of companies so maybe its bad management. My guess is the day the present system becomes unreliable, the Federal government will fund another solution. The luxury of rich, functioning European states... I think we don't have the military sink hole. I was just reading about the Metro North derailment. Many people griping about the poor state of American public transport, not to mention roads and bridges, etc. Comparing to some European utopia.Yet I have heard Germany also faces a big burden because of delayed infrastructure investment. Yeah, its better here, but these sorts of things - the so-called socialist benefits of advanced and mostly capitalist economies - they take constant constant tweaking and constant reinvestment... Reunification cost a shit load. Then during the new crisis, the Germans have preached austerity and thus, yeah, better infrastructure was in place but overall, there are major challenges going forward. Now Britain, trying to sort out how to pay for its top flight university system... The key to me is that a country makes its social welfare commitments and does what is necessary to stick to them... Bush Jr. toured Europe, before the American financial collapse, on a propaganda tour telling heads of states the only model was the American model, and the social welfare states were unsustainable. Then he delivered his epic catastrophe of the pure capitalist formula.

And my simple question begets a long and wonderful answer. I understood all of that but thank you for connecting the dots.

Capitalism has it's benefits and faults. So does any social path forward.... or not.

The bottom line is that we "Americans" (sorry, we "United States of America" folks) are pathetic when it comes to learning from other countries as far as what truly works when it comes to healthcare.

The stats speak for themselves. (see above y'all)

Compassion seems to be lacking here as well as the pure numbers of fiscal responsibility.

They CAN go hand in hand. The Republican's amongst us just DO NOT get it or worse yet are more concerned with their own "careers" and making the corporations who are "people too" their priority over us lowly citizens.

.....just another long reply to the never ending saga of the death panels we are all facing according to the idiots in power today.

Compassion seems to be lacking here as well as the pure numbers of fiscal responsibility.

They CAN go hand in hand. The Republican's amongst us just DO NOT get it or worse yet are more concerned with their own "careers" and making the corporations who are "people too" their priority over us lowly citizens.

Well -- that trait does not belong to Republicans alone. Everyone knows that SS and Medicare need reforming, but the Democrats don't want to talk about it for it will impact their "careers" -- the AARP will be after them. The problem rests not really with the pols -- it rests with us (yes, gerrymandering makes it far more difficult for us to remove the bad ones, but......... it can and has happened)

As for healthcare -- I think Obamacare is an absolutely necessary, but not anyway ideal, first step to where we must get -- Single Payer system. It will take baby steps, unfortunately. From what I am reading (and seeing first hand) is that Obamacare is going to give large companies an avenue to slowly exit the health insurance game -- that is how, I hope, we navigate from here to there. There will be winners and losers along the way and I suspect the "groups" will change in each category over time, but we can't do it in a single leap, so we'll all have to grin and bear it. My hope is that empathy and compassion is shown from both sides of the political spectrum. Without that - that us vs. them only intensifies as "impacts" happen. Neither side is pure evil, neither side is pure altruism -- both have good and not so good ideas.

Well -- that trait does not belong to Republicans alone. Everyone knows that SS and Medicare need reforming, but the Democrats don't want to talk about it for it will impact their "careers" -- the AARP will be after them. The problem rests not really with the pols -- it rests with us (yes, gerrymandering makes it far more difficult for us to remove the bad ones, but......... it can and has happened)

As for healthcare -- I think Obamacare is an absolutely necessary, but not anyway ideal, first step to where we must get -- Single Payer system. It will take baby steps, unfortunately. From what I am reading (and seeing first hand) is that Obamacare is going to give large companies an avenue to slowly exit the health insurance game -- that is how, I hope, we navigate from here to there. There will be winners and losers along the way and I suspect the "groups" will change in each category over time, but we can't do it in a single leap, so we'll all have to grin and bear it. My hope is that empathy and compassion is shown from both sides of the political spectrum. Without that - that us vs. them only intensifies as "impacts" happen. Neither side is pure evil, neither side is pure altruism -- both have good and not so good ideas.

yes -- I continue to be the "fence sitting" moderate in the middle.

M

Hmm... I really hate getting into these discussions with you Mike. Your "moderate in the middle" stance is not moderate or in the middle as much as you think it is. You yourself are saying that a single payer system is what is best. Which political party is working toward that goal? It is certainly NOT the Republican party in this day.

Give me a list of ANY Republican in office. Is it 1 or 10? give me a break!

Yes Dems get influenced by AARP. So what. better than the greed factory of the healthcare industry.

Hmm... I really hate getting into these discussions with you Mike. Your "moderate in the middle" stance is not moderate or in the middle as much as you think it is. You yourself are saying that a single payer system is what is best. Which political party is working toward that goal? It is certainly NOT the Republican party in this day.

Give me a list of ANY Republican in office. Is it 1 or 10? give me a break!

Yes Dems get influenced by AARP. So what. better than the greed factory of the healthcare industry.

Empathy and compassion from the Republicans? LOL. LOL. Show me.

You see -- you read only what you wanted to read in my post -- just enough to refute. Again, as I've said many times to many folks, this is why our political situation is what it is today.When I referred to "empathy and compassion" from both sides -- I wasn't speaking only of politicians, I was speaking of all of us. Also -- people can have stupid ideas and yet be compassionate. Additionally -- why is the AARP power "better" than the healthcare industry?? Do you really think the powers at the AARP care about their members more than they do their own position and LARGE SALARIES?

You take my pointing out the hypocrisy of the left to mean that I support the right, when I support NEITHER. And my thought process in the political realm may be in the minority on this forum but it is where a large chunk of Americans fall.

As for "who is working for a single payer system" -- the answer is simple -- almost no one. If the Dems really wanted it -- we would have had it when they controlled Congress with 60 Senators back in 2009. Ah yes, lobbyists do tend to throw money at the party in power and money does talk to both parties.

What I find more unfortunate is that you and I are far closer to each other on many topics than I am to the far right, but you seem only to focus on how we are different. Even when we agree you use it as a way to denigrate my position. Yes -- I think a Single Payer System is what we need, but there is not enough support on either side for it to happen. The one place we consistently differ is that I don't view the Republicans, in general, as evil -- though I haven't voted for one since I left New England. I respect your position, but I just can't always let one-sided posts go by without giving my thoughts. BTW - William Weld, Claudine Schneider -- two Repubs with empathy and compassion who have gotten my votes in the past. Even Christie has his moments -- like when he put politics on the back burner after Sandy and actually talked and thanked Obama for helping the victims in his state. Not that I am a big Christie fan -- but he has shown empathy and compassion and deserves to get credit for it. Olympia Snowe, Susan Collins also come to mind, I'm sure with time I can come up with more.

Anyway -- I'm sorry you don't like our political discussions -- I always find them interesting, I mean if people with differing views don't even like to discuss them, we'll never get anywhere, because I'm not always right -- but I'm not always wrong either.